HomeMy WebLinkAbout4900 BOARDWALK DR - APPLICATIONS - 5/12/2018Planning, Development d!t TYsnsportatia'
of 281 N. College Ave P.O. Box 580
olllnS Fort Collins, OD 80524 -
phone 970416-2740 Fax 224-6134
OVERwTHE-COUNTER PERMS ONLY
is application is to be used to apply for the tollowfrtg permits only (check all that apply)• 0 Air Conditioning
Demolition {interior non-structural) 0 Electrical Alteration (not service change) ❑Gas Lighter O Gas Log
Hetiag Unit ❑ t_awn Sprinkler ❑ Mobile Home replacement ❑ Roofing 0 Sewer tie 0 FhotDide make, model and
Ventilation Water Heater ❑ Water Line ❑ WoodlPellet Stove (must be EPA termed, Pr
all appfieabis information on the application.
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For ofliice vise ordy
ab Sf a Address (mi )
10 _.__-_
�a
Qpitcant Name
7ontracmr �i/trr �� %y1
�ontracbor City of Ft. Collins Sales Tax
Sww tmrnumberis mquhed bya0 wrivve m
incomplete apAilcadons win not be aatmpted.
Date w f i I z I i
Value of Construction (labor, materials, profit)
<- !?� 57'9- 13
City/state 0.&i A*A zip
Address C,ty/Stift Tip ie�3
Address city/she ?ip 33
ZOa Are you paying taxes here or by report? ❑ Here ,'"eport
Are you paying with your trust a000unt? .Yes ❑ No
Is this a residential or commercial project? XReSWMVW ❑ Commercial
If residential, is ft: 09ri9le. wily Detached 0 Condo/bownhome (single family altadied) 17 Cupp
€.7 Multifamily (apartment) 0 Gw 4e
if commercial, is it: 0 Bank 13 ear 0 Church 0 FoWft9otel ❑ Medical 0180e ❑ Office O Rail
❑ Restaurant ❑ other (explain)
Is this building so years of age or more? ❑ Yes ONO lfy you mayreeed to contact Hcsmric presPlvab47n
If this is for a demolition permit, what year Was the buililling conshvcted?
Ifprfor to .075, you wNI need an a 0esbas asse� to w&nir MM Mls 4waador►.
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*If lawn sprinider/bactdtow preventer, must list tieensed plumber. If first-time A/C, must fist ficensed electrician.
!List the ea-RAmy name or City of CerWlkero #
E3KWtan Plumber_______.;,: Mediankel wer Oilier
I hereby adatowledge that I have read this appkatfon and state that the above ftf notion Is complete and cwreet. I agree to
compiy with all requirements contained herein and dty ordinances and stabs laws regulating building consbruobon. I knarw that a .
permit Is not valid until it has been paid and Issued.
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6'd 91,170-M7-OL6 Auodwoo eolties uuewlle d£0:L0'86 9l APN